Adoption Application

Adoption Application

Step 1 of 3

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PLEASE NOTE THIS IS A LONG FORM, THANK YOU FOR HANGING IN THERE THROUGH THE APPLICATION!

Please read and complete the entire application. An application that has any blanks will NOT be processed. Once a form is submitted you will receive a confirmation it was received via email and we will review the application and contact you within 24-48 hours. HHBR has the right to refuse adoption to any applicant at any time.

If there are ANY questions please do not hesitate to contact us at hhbriowa@gmail.com.

Name*

FirstLast

Email Address*

Adoptings person(s) agrees to contact the above stated rescue immediately if the rescue dog is lost or stolen.*

Yes

No

Adopting person(s) agrees that the rescue dog will be a house pet and will receive all care and attention necessary to ensure its health and well-being. Adopting person(s) will provide adequate food, fresh water, shelter, exercise, veterinary care (including yearly inoculations and monthly heartworm prevention) as recommended by atteneting veterinarian, and licesnce said dog in accorance to state and local laws.*

Yes

No

Adopting person(s) agrees to purchase Heartworm preventative for the rescue dog (i.e. Interceptor, Heartguard, Sentinel, Revolution) within two weeks of agreement date and to keep the rescue dog on the preventative for the duration of the rescue dog’s life*

Yes

No

Adopting person(s) will not permit the dog to run free or off-leash or out of immediate control. When outside, the dog will never be staked or chained.*

Adopting person(s) will not transport the dog in an open pickup bed or boat.*

Yes

No

Adopting person(s) agrees that the dog will, at all times, wear a buckle collar with current rabies tag.*

Yes

No

Adopting person(s) will contact above stated rescue at least one week prior to any change of address.*

Yes

No

Adopting person(s) will keep the rescue dog for so long as it shall live and will not transfer the ownership to any other person, firm, corporation, or organization for any reason.*

Yes

No

If custody of the rescue dog must be relinquished, adopting person(s) agrees to notify the above stated rescue immediately to arrange for its re-adoption.*

Yes

No

The adopting person(s) takes the rescue dog as is, with all conditions either observable or unobservable and assumes full risk for the dog from the date of signing an adoption agreement.*

Yes

No

The above named rescue has discretion in the refund of the adoption fee in part or in entirety at anytime after the adoption has taken place.*

Yes

No

Adopting person(s) agrees that any rescue dog adoption is contingent upon the completion of a home visit, with the rescue dog present, by a Hounds Haven representative. Adopting person(s) acknowledges and agrees that if the Basset rescue volunteer (in its sole discretion) determines that any violation of the above conditions exist, the above names rescue is authorized to immediately retake custody of the dog.*